Cargando…

Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation

Posttransplant nodular regenerative hyperplasia (NRH) mostly remains unexplained. Microvascular injury due to antibody-mediated rejection (AMR) is suspected, but lack of donor specific antibody (DSA) testing makes it difficult to prove. Centered around a 1-year period of routine DSA testing, concomi...

Descripción completa

Detalles Bibliográficos
Autores principales: Sebagh, Mylène, Yilmaz, Funda, Kounis, Ilias, Saliba, Faouzi, Feray, Cyrille, Taupin, Jean-Luc, Cherqui, Daniel, Azoulay, Daniel, Samuel, Didier, Coilly, Audrey, Demetris, Antony-Jake, Neil, Desley
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10409867/
https://www.ncbi.nlm.nih.gov/pubmed/37565050
http://dx.doi.org/10.3389/ti.2023.11306
_version_ 1785086340430299136
author Sebagh, Mylène
Yilmaz, Funda
Kounis, Ilias
Saliba, Faouzi
Feray, Cyrille
Taupin, Jean-Luc
Cherqui, Daniel
Azoulay, Daniel
Samuel, Didier
Coilly, Audrey
Demetris, Antony-Jake
Neil, Desley
author_facet Sebagh, Mylène
Yilmaz, Funda
Kounis, Ilias
Saliba, Faouzi
Feray, Cyrille
Taupin, Jean-Luc
Cherqui, Daniel
Azoulay, Daniel
Samuel, Didier
Coilly, Audrey
Demetris, Antony-Jake
Neil, Desley
author_sort Sebagh, Mylène
collection PubMed
description Posttransplant nodular regenerative hyperplasia (NRH) mostly remains unexplained. Microvascular injury due to antibody-mediated rejection (AMR) is suspected, but lack of donor specific antibody (DSA) testing makes it difficult to prove. Centered around a 1-year period of routine DSA testing, concomitant protocol, and indicated posttransplant liver biopsies (LB), recipients with NRH (n = 18) were compared with a matched control group (n = 36). All index, previous, and subsequent LB were reviewed. Both groups were similar in terms of demographics, timing of index LB, and DSA. In the index LB, the NRH group had higher sinusoidal C4d positivity (p = 0.029) and perisinusoidal fibrosis (p = 0.034), both independently associated with NRH (p = 0.038 and 0.050, respectively). Features of “possible” chronic AMR were detected in 28.5% of the NRH group without a known cause and 0% of the control group (p = 0.009). The NRH group had more preceding indicated LB with increased incidence of rejection and biliary obstruction pattern. In the follow-up histology, overall, sinusoidal and portal C4d positivity, sinusoidal microvasculitis, and perisinusoidal fibrosis were also higher (all p < 0.050). In conclusion, we provide evidence towards the hypothesis that some cases of posttransplant NRH are related to preceding active and persistent AMR. Large multicenter studies with protocol DSA testing are required to confirm.
format Online
Article
Text
id pubmed-10409867
institution National Center for Biotechnology Information
language English
publishDate 2023
publisher Frontiers Media S.A.
record_format MEDLINE/PubMed
spelling pubmed-104098672023-08-10 Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation Sebagh, Mylène Yilmaz, Funda Kounis, Ilias Saliba, Faouzi Feray, Cyrille Taupin, Jean-Luc Cherqui, Daniel Azoulay, Daniel Samuel, Didier Coilly, Audrey Demetris, Antony-Jake Neil, Desley Transpl Int Health Archive Posttransplant nodular regenerative hyperplasia (NRH) mostly remains unexplained. Microvascular injury due to antibody-mediated rejection (AMR) is suspected, but lack of donor specific antibody (DSA) testing makes it difficult to prove. Centered around a 1-year period of routine DSA testing, concomitant protocol, and indicated posttransplant liver biopsies (LB), recipients with NRH (n = 18) were compared with a matched control group (n = 36). All index, previous, and subsequent LB were reviewed. Both groups were similar in terms of demographics, timing of index LB, and DSA. In the index LB, the NRH group had higher sinusoidal C4d positivity (p = 0.029) and perisinusoidal fibrosis (p = 0.034), both independently associated with NRH (p = 0.038 and 0.050, respectively). Features of “possible” chronic AMR were detected in 28.5% of the NRH group without a known cause and 0% of the control group (p = 0.009). The NRH group had more preceding indicated LB with increased incidence of rejection and biliary obstruction pattern. In the follow-up histology, overall, sinusoidal and portal C4d positivity, sinusoidal microvasculitis, and perisinusoidal fibrosis were also higher (all p < 0.050). In conclusion, we provide evidence towards the hypothesis that some cases of posttransplant NRH are related to preceding active and persistent AMR. Large multicenter studies with protocol DSA testing are required to confirm. Frontiers Media S.A. 2023-07-26 /pmc/articles/PMC10409867/ /pubmed/37565050 http://dx.doi.org/10.3389/ti.2023.11306 Text en Copyright © 2023 Sebagh, Yilmaz, Kounis, Saliba, Feray, Taupin, Cherqui, Azoulay, Samuel, Coilly, Demetris and Neil. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Health Archive
Sebagh, Mylène
Yilmaz, Funda
Kounis, Ilias
Saliba, Faouzi
Feray, Cyrille
Taupin, Jean-Luc
Cherqui, Daniel
Azoulay, Daniel
Samuel, Didier
Coilly, Audrey
Demetris, Antony-Jake
Neil, Desley
Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation
title Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation
title_full Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation
title_fullStr Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation
title_full_unstemmed Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation
title_short Evidence for Alloimmune Sinusoidal Injury in De Novo Nodular Regenerative Hyperplasia After Liver Transplantation
title_sort evidence for alloimmune sinusoidal injury in de novo nodular regenerative hyperplasia after liver transplantation
topic Health Archive
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10409867/
https://www.ncbi.nlm.nih.gov/pubmed/37565050
http://dx.doi.org/10.3389/ti.2023.11306
work_keys_str_mv AT sebaghmylene evidenceforalloimmunesinusoidalinjuryindenovonodularregenerativehyperplasiaafterlivertransplantation
AT yilmazfunda evidenceforalloimmunesinusoidalinjuryindenovonodularregenerativehyperplasiaafterlivertransplantation
AT kounisilias evidenceforalloimmunesinusoidalinjuryindenovonodularregenerativehyperplasiaafterlivertransplantation
AT salibafaouzi evidenceforalloimmunesinusoidalinjuryindenovonodularregenerativehyperplasiaafterlivertransplantation
AT feraycyrille evidenceforalloimmunesinusoidalinjuryindenovonodularregenerativehyperplasiaafterlivertransplantation
AT taupinjeanluc evidenceforalloimmunesinusoidalinjuryindenovonodularregenerativehyperplasiaafterlivertransplantation
AT cherquidaniel evidenceforalloimmunesinusoidalinjuryindenovonodularregenerativehyperplasiaafterlivertransplantation
AT azoulaydaniel evidenceforalloimmunesinusoidalinjuryindenovonodularregenerativehyperplasiaafterlivertransplantation
AT samueldidier evidenceforalloimmunesinusoidalinjuryindenovonodularregenerativehyperplasiaafterlivertransplantation
AT coillyaudrey evidenceforalloimmunesinusoidalinjuryindenovonodularregenerativehyperplasiaafterlivertransplantation
AT demetrisantonyjake evidenceforalloimmunesinusoidalinjuryindenovonodularregenerativehyperplasiaafterlivertransplantation
AT neildesley evidenceforalloimmunesinusoidalinjuryindenovonodularregenerativehyperplasiaafterlivertransplantation